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Africa CDC and WHO have updated their joint Continental Response Plan for the mpox emergency as the disease continues to affect new areas. The revised strategy focuses on controlling outbreaks, while expanding vaccination coverage and transitioning toward a longer-term, sustainable response. 

Mpox is a viral illness that spreads between people, mainly through close contact. It causes painful skin and mucosal lesions, often accompanied by fever, headache, muscle aches, back pain, fatigue, and swollen lymph nodes. The disease can be debilitating and disfiguring. 

Historically a zoonotic disease transmitted from infected animals, mpox has increasingly shown a tendency to spread between people. In 2022, a variant of the virus, clade IIb, began spreading globally through sexual contact. Since late 2023, yet another viral strain, clade Ib, began spreading through sexual networks and within households and through close contact. This prompted Africa CDC to declare a Public Health Emergency of Continental Security and the WHO Director-General to declare a Public Health Emergency of International Concern in August 2024. 

By August 2024, the virus had begun spreading from the Democratic Republic of the Congo to 4 neighbouring countries. Since then, 28 countries around the world have reported cases of mpox due to clade Ib. Outside Africa, cases remain largely travel-related. However, within Africa, in addition to transmission in Burundi, the Democratic Republic of the Congo, Kenya, Rwanda and Uganda, local transmission has now been documented in additional countries including the Republic of the Congo, South Africa, South Sudan, the United Republic of Tanzania and Zambia. 

Since the declaration of the emergency, both regional and global support has increased, particularly for the Democratic Republic of the Congo, the epicentre of the outbreak. The Africa CDC and WHO Joint Continental Mpox Plan has guided these efforts, focusing on ten key pillars: coordination, risk communication and community engagement, disease surveillance, laboratory capacity, clinical management, infection prevention and control, vaccination, research, logistics, and maintaining essential health services. 

Vaccination efforts are underway, with more than 650 000 doses administered in 6 countries, 90% of which have been administered in the Democratic Republic of the Congo. Overall, over a million doses have been delivered to 10 countries, with efforts ongoing to secure additional vaccine supplies. 

Diagnostic testing capacity in the Democratic Republic of the Congo has grown significantly, driven by the expansion of laboratory infrastructure - from 2 laboratories in late 2023 to 23 laboratories in 12 provinces today. With new, near-point-of-care tests currently being rolled out in the country, capacity is expected to increase even further. 

Despite this progress, major challenges remain. Ongoing conflict and insecurity in eastern Democratic Republic of the Congo, where the incidence of mpox remains high, as well as humanitarian aid cuts, continue to limit the public health response and restrict access to essential services. Across countries and partners, over US$ 220 million is needed to fill funding gaps for the mpox response.  

The updated Continental Response Plan calls for intensified efforts to bring outbreaks under control, while also taking concrete actions to integrate mpox into routine health services.  

Along with the Continental Response Plan for Africa, WHO has updated the global strategic plan to curb - and where feasible, to stop - human-to-human transmission of mpox. In the first two months of 2025, 60 countries reported mpox, with the majority of cases and deaths reported from the African continent.  The joint Continental Response Plan is aligned with the global strategy. 

Africa CDC and WHO continue to work closely with national governments, local communities, and partners to curb transmission, control the outbreak, and build longer-term resilience within public health systems. 

After more than three years of intensive negotiations, WHO Member States took a major step forward in efforts to make the world safer from pandemics, by forging a draft agreement for consideration at the upcoming World Health Assembly in May. The proposal aims to strengthen global collaboration on prevention, preparedness and response to future pandemic threats.

In December 2021, at the height of the COVID-19 pandemic, WHO Member States established the Intergovernmental Negotiating Body (INB) to draft and negotiate a convention, agreement or other international instrument, under the WHO Constitution, to strengthen pandemic prevention, preparedness and response.

Following 13 formal rounds of meetings, nine of which were extended, and many informal and intersessional negotiations on various aspects of the draft agreement, the INB today finalized a proposal for the WHO Pandemic Agreement. The outcome of the INB’s work will now be presented to the Seventy-eighth World Health Assembly for its consideration.

"The nations of the world made history in Geneva today," said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. "In reaching consensus on the Pandemic Agreement, not only did they put in place a generational accord to make the world safer, they have also demonstrated that multilateralism is alive and well, and that in our divided world, nations can still work together to find common ground, and a shared response to shared threats. I thank WHO's Member States, and their negotiating teams, for their foresight, commitment and tireless work. We look forward to the World Health Assembly's consideration of the agreement and – we hope – its adoption."

Proposals within the text developed by the INB include establishing a pathogen access and benefit sharing system; taking concrete measures on pandemic prevention, including through a One Health approach; building geographically diverse research and development capacities; facilitating the transfer of technology and related knowledge, skills and expertise for the production of pandemic-related health products; mobilizing  a skilled, trained and multidisciplinary national and global health emergency workforce; setting up a coordinating financial mechanism; taking concrete measures to strengthen preparedness, readiness and health system functions and resilience; and establishing a global supply chain and logistics network.

The proposal affirms the sovereignty of countries to address public health matters within their borders, and provides that nothing in the draft agreement shall be interpreted as providing WHO any authority to direct, order, alter or prescribe national laws or policies, or mandate States to take specific actions, such as ban or accept travellers, impose vaccination mandates or therapeutic or diagnostic measures or implement lockdowns.

Dr Tedros paid tribute to the members of the Bureau who guided the INB process: Co-Chairs Ms Precious Matsoso (South Africa) and Ambassador Anne-Claire Amprou (France), and Vice-Chairs Ambassador Tovar da Silva Nunes (Brazil), Ambassador Amr Ramadan (Egypt), Dr Viroj Tangcharoensathien (Thailand); and Ms Fleur Davies (Australia). Past members included former Co-Chair, Mr Roland Driece (the Netherlands), and former Vice-Chairs Ambassador Honsei Kozo (Japan), Mr Kazuho Taguchi (Japan), and Mr Ahmed Soliman (Egypt). The Director-General also acknowledged the constant support provided by WHO Secretariat colleagues.

INB Co-Chair Ms Matsoso said: “I am overjoyed by the coming together of countries, from all regions of the world, around a proposal to increase equity and, thereby, protect future generations from the suffering and losses we suffered during the COVID-19 pandemic. The negotiations, at times, have been difficult and protracted. But this monumental effort has been sustained by the shared understanding that viruses do not respect borders, that no one is safe from pandemics until everyone is safe, and that collective health security is an aspiration we deeply believe in and want to strengthen.”

Fellow INB Co-Chair, Ambassador Amprou, said the draft agreement is a major step in strengthening the global health security architecture so people of the world would be better protected from the next pandemic.

“In drafting this historic agreement, the countries of the world have demonstrated their shared commitment to preventing and protecting everyone, everywhere, from future pandemic threats,” Ambassador Amprou said. “While the commitment to prevention through the One Health approach is a major step forward in protecting populations, the response will be faster, more effective and more equitable. This is a historic agreement for health security, equity and international solidarity.”

The INB was established in December 2021, at a special session of the World Health Assembly, bringing together Member States and relevant stakeholders, including international organizations, private sector, and civil society. At the World Health Assembly in June 2024, governments made concrete commitments to complete negotiations on a global pandemic agreement within a year. The upcoming Assembly starting 19 May 2025 will consider the proposal developed by the INB and take the final decision on whether to adopt the instrument under Article 19 of the WHO Constitution.

The World Health Organization (WHO) issues warning on health service disruptions reported in 70% of its surveyed country offices as a result of sudden suspensions and reductions in official development assistance (ODA) for health.

The findings, based on rapid WHO assessment of the fast-evolving situation, raise concern for potentially deeper and prolonged effects on health systems and services across the world, especially in vulnerable and fragile settings. This requires urgent action and international response.

The new rapid stock take conducted in March–April 2025 with 108 WHO country offices, primarily in low- and lower-middle-income countries, shows that many countries are working to increase or reallocate funding from domestic and alternative external sources to address gaps. However, up to 24% of WHO Country Office responses suggest budget cuts are already translating into increased out-of-pocket payments. The poor and vulnerable likely risk bearing the additional brunt of these impacts.

“These results paint a worrying picture about the impact of the sudden and unplanned cuts to aid on the health of millions of people,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Although these cuts are a shock, they are also driving an accelerated transition away from aid dependency to a more sustainable self-reliance, based on domestic resources. Many countries are asking for WHO’s support, and WHO is working with them to identify and tailor the most effective measures.”

The stock take reports provide an early snapshot and insights from WHO country offices that work closely with ministries of health, providing regular support on health systems policies and planning. The stock take aimed at identifying the urgent support countries need to avoid catastrophic impacts on the health of the populations and to guide monitoring of the rapidly evolving situation. 

Key findings from the stock take show the following.

• The suspensions and reductions in ODA are disrupting all health system functions, with the most frequently reported impacts being on health emergency preparedness and response (70%), public health surveillance (66%), service provision (58%), humanitarian aid (56%), and the health and care workforce (54%).
• Health services are being disrupted across the board in at least one third of the responding countries, with high levels of disruptions reported in outbreak detection and response, malaria, HIV, tuberculosis, sexually transmitted infections, family planning, and maternal and child health services.
• The nature and scale of service disruptions are comparable to those observed during the peak periods of the COVID-19 pandemic in some settings. 
• Critical shortages in the availability of medicines and health products are leaving one third of responding countries without commodities for major service areas.
• The pause in ODA has led to job losses for health and care workers in over half of responding countries, and significant disruptions to trainings.

• Information systems are particularly impacted as key health data collection is disrupted. Over 40% of countries experienced disruptions to key information systems, including collaborative surveillance and emergency systems, health management information systems, disease-specific reporting systems, lab information systems, and household/population surveys.
• Eighty-one of the 108 WHO country offices have expressed the need for support across a broad range of health areas, including innovative funding and resource mobilization, targeted technical assistance and support.

Given the rapidly evolving context, WHO will be monitoring the situation over time and will engage the global health community, including partners and donor agencies, to inform urgent response plans to mitigate deepening country impacts and enable greater sustainability.  

Note to editors:

These findings represent a snapshot of the health systems and health services situation in the context of a rapidly evolving situation. Senior WHO country office staff were surveyed over the period of 7 March to 2 April 2025 to provide inputs and observations on the impact of ODA suspensions and reductions through a structured survey. WHO country offices in low- and lower-middle-income countries across all six WHO regions were included in this survey. They do not reflect the official views of the governments in the countries, territories and areas. WHO has a global presence in 150+ locations putting central focus on countries and populations, working to protect and improve the health of everyone, everywhere. More information.

The World Health Organization (WHO) has today published its first-ever global guidelines for meningitis diagnosis, treatment and care, aiming to speed up detection, ensure timely treatment, and improve long-term care for those affected. By bringing together the latest evidence-based recommendations, the guidelines provide a critical tool for reducing deaths and disability caused by the disease.

Despite effective treatments and vaccines against some forms of meningitis, the disease remains a significant global health threat. Bacterial meningitis is the most dangerous form and can become fatal within 24 hours. Many pathogens can cause meningitis with an estimated 2.5 million cases reported globally in 2019. This includes 1.6 million cases of bacterial meningitis which resulted in approximately 240 000 deaths.

Around 20% of people who contract bacterial meningitis develop long-term complications, including disabilities that impact quality of life. The disease also carries heavy financial and social costs for individuals, families, and communities.

“Bacterial meningitis kills one in six of the people it strikes, and leaves many others with lasting health challenges," said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. "Implementing these new guidelines will help save lives, improve long-term care for those affected by meningitis, and strengthen health systems."

Meningitis can affect anyone anywhere, and at any age, however the disease burden remains particularly high in low- and middle-income countries and in settings experiencing large-scale epidemics.  The highest burden of disease is seen in a region of sub-Saharan Africa, often referred to as the ‘meningitis belt’, which is at high risk of recurrent epidemics of meningococcal meningitis.

Improving clinical management of meningitis is essential to reducing mortality and morbidity, minimizing long-term complications and disability, and improving quality of life for affected individuals and communities.

The new guidelines provide evidence-based recommendations for the clinical management of children over one month of age, adolescents, and adults with acute community-acquired meningitis.

They address all aspects of clinical care, including diagnosis, antibiotic therapy, adjunctive treatment, supportive care, and management of long-term effects.  Given the similarities in clinical presentation, diagnosis and management approaches across different forms of acute community-acquired meningitis, the guidelines address both bacterial and viral causes.

The guidelines provide recommendations for both non-epidemic and epidemic settings, the latter superseding previous 2014 WHO guidelines, which covered  meningitis outbreak response.

As resource-limited settings bear the highest burden of meningitis, these guidelines have been specifically developed to provide technical guidance suitable for implementation in low- and middle-income countries.

The guidelines are intended for use by health-care professionals in first- and second-level facilities, including emergency, inpatient, and outpatient services. Policymakers, health planners, academic institutions, and civil society organizations can also use them to inform capacity-building, education, and research efforts.

The guidelines contribute to the broader Defeating Meningitis by 2030 Global Roadmap, adopted by WHO Member States in 2020, which aims to: eliminate bacterial meningitis epidemics, reduce cases of vaccine-preventable bacterial meningitis by 50% and deaths by 70%, and reduce disability and improve quality of life after meningitis.

Achieving these goals requires coordinated action across five key areas:

1. Diagnosis and treatment: Faster detection and optimal clinical management.
2. Prevention and epidemic control: Developing new affordable vaccines, achieving high immunization and coverage, and improving outbreak preparedness and response.
3. Disease surveillance: Strengthening monitoring systems to guide prevention and control.
4. Care and support for those affected by meningitis: Ensuring early recognition and improved access to care and support for after-effects from meningitis. 
5. Advocacy and engagement: Increasing political commitment and inclusion in country plans, better public understanding of meningitis, and increased awareness of right to prevention, care and after-care services.

With these guidelines, WHO provides countries with a critical tool to close gaps in meningitis diagnosis, treatment and care, ensuring that more people receive timely treatment and long-term support.

Women today are more likely than ever to survive pregnancy and childbirth according to a major new report released today, but United Nations (UN) agencies highlight the threat of major backsliding as unprecedented aid cuts take effect around the world.

Released on World Health Day, the UN report, Trends in maternal mortality, shows a 40% global decline in maternal deaths between 2000 and 2023 – largely due to improved access to essential health services. Still, the report reveals that the pace of improvement has slowed significantly since 2016, and that an estimated 260 000 women died in 2023 as a result of complications from pregnancy or childbirth – roughly equivalent to one maternal death every two minutes.

The report comes as humanitarian funding cuts are having severe impacts on essential health care in many parts of the world, forcing countries to roll back vital services for maternal, newborn and child health. These cuts have led to facility closures and loss of health workers, while also disrupting supply chains for lifesaving supplies and medicines such as treatments for haemorrhage, pre-eclampsia and malaria – all leading causes of maternal deaths.

Without urgent action, the agencies warn that pregnant women in multiple countries will face severe repercussions – particularly those in humanitarian settings where maternal deaths are already alarmingly high.

“While this report shows glimmers of hope, the data also highlights how dangerous pregnancy still is in much of the world today despite the fact that solutions exist to prevent and treat the complications that cause the vast majority of maternal deaths,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO). “In addition to ensuring access to quality maternity care, it will be critical to strengthen the underlying health and reproductive rights of women and girls – factors that underpin their prospects of healthy outcomes during pregnancy and beyond.”

The report also provides the first global account of the COVID-19 pandemic’s impact on maternal survival. In 2021, an estimated 40 000 more women died due to pregnancy or childbirth – increasing to 322 000 from 282 000 the previous year. This upsurge was linked not only to direct complications caused by COVID-19, but also widespread interruptions to maternity services. This highlights the importance of ensuring such care during pandemics and other emergencies, noting that pregnant women need reliable access to routine services and checks as well as round-the-clock urgent care.

“When a mother dies in pregnancy or childbirth, her baby’s life is also at risk. Too often, both are lost to causes we know how to prevent,” said UNICEF Executive Director Catherine Russell. “Global funding cuts to health services are putting more pregnant women at risk, especially in the most fragile settings, by limiting their access to essential care during pregnancy and the support they need when giving birth. The world must urgently invest in midwives, nurses, and community health workers to ensure every mother and baby has a chance to survive and thrive.”

The report highlights persistent inequalities between regions and countries, as well as uneven progress. With maternal mortality declining by around 40% between 2000 and 2023, sub-Saharan Africa achieved significant gains – and was one of just three UN regions alongside Australia and New Zealand, and Central and Southern Asia, to see significant drops after 2015. However, confronting high rates of poverty and multiple conflicts, the sub-Saharan Africa region still counted for approximately 70% of the global burden of maternal deaths in 2023.

Indicating slowing progress, maternal mortality stagnated in five regions after 2015: Northern Africa and Western Asia, Eastern and South-Eastern Asia, Oceania (excluding Australia and New Zealand), Europe and North America, and Latin America and the Caribbean.

“Access to quality maternal health services is a right, not a privilege, and we all share the urgent responsibility to build well-resourced health systems that safeguard the life of every pregnant woman and newborn,” said Dr Natalia Kanem, UNFPA’s Executive Director. “By boosting supply chains, the midwifery workforce, and the disaggregated data needed to pinpoint those most at risk, we can and must end the tragedy of preventable maternal deaths and their enormous toll on families and societies.”

Pregnant women living in humanitarian emergencies face some of the highest risks globally, according to the report.Nearly two-thirds of global maternal deaths now occur in countries affected by fragility or conflict. For women in these settings, the risks are staggering: a 15-year-old girl faces a 1 in 51 risk of dying from a maternal cause at some point over her lifetime compared to 1 in 593 in more stable countries. The highest risks are in Chad and the Central African Republic (1 in 24), followed by Nigeria (1 in 25), Somalia (1 in 30), and Afghanistan (1 in 40).

Beyond ensuring critical services during pregnancy, childbirth and the postnatal period, the report notes the importance of efforts to enhance women’s overall health by improving access to family planning services, as well as preventing underlying health conditions like anaemias, malaria and noncommunicable diseases that increase risks. It will also be critical to ensure girls stay in school and that women and girls have the knowledge and resources to protect their health.

Urgent investment is needed to prevent maternal deaths. The world is currently off-track to meet the UN’s Sustainable Development Goal target for maternal survival. Globally, the maternal mortality ratio would need to fall by around 15% each year to meet the 2030 target – significantly increasing from current annual rates of decline of around 1.5%.

About the United Nations Maternal Mortality Estimation Inter-Agency Group
The report was produced by WHO on behalf of the United Nations Maternal Mortality Estimation Inter-Agency Group comprising WHO, UNICEF, UNFPA, the World Bank Group and the Population Division of the United Nations Department of Economic and Social Affairs. It uses national data to estimate levels and trends of maternal mortality from 2000–2023. The data in this new publication covers 195 countries and territories. It supersedes all previous estimates published by WHO and the United Nations Maternal Mortality Estimation Inter-Agency Group.

About the data
The SDG target for maternal deaths is for a global maternal mortality ratio (MMR) of less than 70 maternal deaths per 100 000 live births by 2030. The global MMR in 2023 was estimated at 197 maternal deaths per 100 000 live births, down from 211 in 2020 and from 328 in 2000.

The report includes data disaggregated by the following regions, used for SDG reporting: Central Asia and Southern Asia; Sub-Saharan Africa; Northern America and Europe; Latin America & the Caribbean; Western Asia and Northern Africa; Australia and New Zealand; Eastern Asia and South-eastern Asia, and Oceania excluding Australia and New Zealand.

A maternal death is a death due to complications related to pregnancy or childbirth, occurring when a woman is pregnant, or within six weeks of the end of the pregnancy.

About World Health Day
World Health Day is marked around the world on 7 April. Each year, it draws attention to a specific health topic of concern to people all over the world. The World Health Day 2025 campaign focuses on improving maternal and newborn health and survival with the theme “Healthy beginnings, hopeful futures”. The campaign urges governments and the health community to ramp up efforts to end preventable maternal and newborn deaths, and to prioritize women’s longer-term health and well-being.

Over the past two days, WHO convened more than 15 countries and over 20 regional health agencies, health emergency networks and other partners to test, for the first time, a new global coordination mechanism for health emergencies.

The two-day simulation, Exercise Polaris, tested WHO’s Global Health Emergency Corps (GHEC), a framework designed to strengthen countries’ emergency workforce, coordinate the deployment of surge teams and experts, and enhance collaboration between countries.

The exercise simulated an outbreak of a fictional virus spreading across the world.

Participating countries included Canada, Colombia, Costa Rica, Denmark, Ethiopia, Germany, Iraq, Kingdom of Saudi Arabia, Mozambique, Nepal, Pakistan, Qatar, Somalia Uganda and Ukraine, with additional countries as observers. Each country participated through its national health emergency coordination structure and worked under real-life conditions to share information, align policies and activate their response.

Regional and global health agencies and organizations, including Africa CDC, European CDC, IFRC, IOM, UNICEF and established emergency networks such as the Global Outbreak Alert and Response Network, the Emergency Medical Teams initiative, Stand-by partners and the International Association of National Public Health Institutes, worked together to support country-led responses. More than 350 health emergency experts connected globally through this exercise.

“This exercise proves that when countries lead and partners connect, the world is better prepared,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “No country can face the next pandemic alone. Exercise Polaris shows that global cooperation is not only possible – it is essential.”

Throughout the simulation, countries led their own response efforts while engaging with WHO for coordination, technical guidance and emergency support. The exercise provided a rare opportunity for governments to test preparedness in a realistic environment, one where trust and mutual accountability were as critical as speed and capacity.

“The exercise sought to put into practice the procedures for inter-agency response to international health threats. Efficient coordination and interoperability processes are key to guaranteeing timely interventions in health emergencies,” said Dr Mariela Marín, Vice Minister of Health of Costa Rica, thanking the Pan American Health Organization for their support and the members of the National Risk Management System for their engagement.

“Polaris demonstrated the critical importance of cultivating trust before a crisis occurs,” said Dr Soha Albayat from Qatar. “The foundation of our collaborative efforts is significantly stronger than in years past. We've moved beyond reactive measures, and are now proactively anticipating, aligning, and coordinating our cross-border emergency response plans.”

“The Global Health Emergency Corps has evolved into a powerful platform, building on practice, trust and connection,” said Dr Mike Ryan, Executive Director of WHO’s Health Emergencies Programme. “Exercise Polaris showed what is possible when countries operate with urgency and unity supported by well-connected partners. It is a strong signal that we are collectively more ready than we were.”

At a time when multilateralism is under pressure and preparedness is often framed through a national lens, Exercise Polaris reaffirmed that health is a global issue.

The World Health Organization (WHO) today launched new guidance to help all countries reform and strengthen mental health policies and systems. Mental health services worldwide remain underfunded, with major gaps in access and quality. In some countries, up to 90% of people with severe mental health conditions receive no care at all, while many existing services rely on outdated institutional models that fail to meet international human rights standards.

The guidance provides a clear framework to transform mental health services in line with the latest evidence and international human rights standards, ensuring quality care is accessible to all.

"Despite rising demand, quality mental health services remain out of reach for many people," said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. "This new guidance gives all governments the tools to promote and protect mental health and build systems that serve everyone.”

While effective prevention and treatment interventions exist, most people living with mental health conditions do not have access to these. The new WHO guidance sets out concrete actions to help countries close these gaps and ensure mental health is promoted and protected, with a focus on:

• protecting and upholding human rights, ensuring mental health policies and services are aligned with international human rights standards;
• promoting holistic care with an emphasis on lifestyle and physical health, psychological, social, and economic interventions;
• addressing social and economic factors that shape and affect mental health including employment, housing and education;
• implementing prevention strategies and promote population-wide mental health and well-being; and
• ensuring people with lived experience are empowered to participate in policy planning and design to ensure mental health policies and services are responsive to their needs.

The guidance identifies five key policy areas requiring urgent reform: leadership and governance, service organization, workforce development, person-centred interventions, and addressing social and structural determinants of mental health.

The WHO guidance serves as a critical tool for governments, policymakers, and stakeholders working to strengthen mental health systems and improve access to mental health care.

By offering a menu of policy directives, strategies and actions to guide reform efforts, the guidance supports policy makers to prioritize and tailor policies to their specific national context, in line with their available resources and operational structures.

"This new WHO guidance provides practical strategies for countries to build inclusive, responsive and resilient mental health systems. Designed to be flexible, it allows all countries – whether low- middle- or high-income - to adapt their approach to mental health care based on national context, needs, and priorities,” said Dr Michelle Funk, Unit Head, Policy, Law and Human Rights in the WHO Department for Mental Health and Substance Abuse.

The guidance was developed in consultation with global experts, policymakers and individuals with lived experience. The policy guidance also builds on the resources, guidance and tools developed under the WHO QualityRights initiative, aiming to promote a person-centred, recovery-oriented and rights-based approach to mental health. WHO will support countries in implementing the guidance through technical assistance and capacity-building initiatives.

The WHO Technical Advisory Group on COVID-19 Vaccine Composition (TAG-CO-VAC) continues to closely monitor the genetic and antigenic evolution of SARS-CoV-2 variants, immune responses to SARS-CoV-2 infection and COVID-19 vaccination, and the performance of COVID-19 vaccines against circulating variants. Based on these evaluations, WHO advises vaccine manufacturers and regulatory authorities on the implications for future updates to COVID-19 vaccine antigen composition. The next decision-making meeting of the TAG-CO-VAC is scheduled for May 2025, after which a statement on COVID-19 vaccine antigen composition and an accompanying data annex will be published on the WHO website. These meetings are timed to balance the availability of the latest epidemiological, immunological, and virological data, with the kinetics of vaccine-induced protection and the lead time manufacturers need to update the antigen composition of authorized COVID-19 vaccines.

The purpose of this statement is to guide the scientific community and vaccine manufacturers as to which data should be generated ahead of the May 2025 TAG-CO-VAC deliberations. It is an update to the previous statement on the types of data requested in October 2024.1

To inform decisions on COVID-19 vaccine antigen composition,2-6 the TAG-CO-VAC reviews data (see Table) on the genetic evolution of SARS-CoV-2 and the antigenic characteristics of previously and currently circulating variants. This includes the analysis of animal antisera following primary infection or vaccination in one-way and two-way neutralization tests, as well as immunogenicity data that assess the breadth and durability of immune responses, including neutralizing antibody responses, using sera from sequentially immunized or infected animals and pre-and post-vaccination human sera. The TAG-CO-VAC also considers vaccine effectiveness (VE) estimates of currently approved COVID-19 vaccines, particularly those that control for time since vaccination and that provide variant-specific estimates across different vaccine platforms for protection against any infection, symptomatic disease, and severe disease. Further examples of published data reviewed by TAG-CO-VAC and used to inform decisions on COVID-19 vaccine antigen composition can be found in the annexes accompanying each of the previous statements.2-6

In addition, the TAG-CO-VAC reviews available data from vaccine manufacturers, including animal and human studies demonstrating the breadth and durability of immune responses elicited by currently authorized vaccines, as well as any vaccine candidates in development. For vaccine candidates in development, the TAG-CO-VAC highlights the utility of clinical immunogenicity data for decision-making on COVID-19 vaccine antigen composition. The TAG-CO-VAC also notes that comparable immunogenicity data (i.e. to the same variants) from previous vaccine compositions are especially useful. Vaccine manufacturers are also asked to provide observational epidemiological data that demonstrate the efficacy or effectiveness of their authorized COVID-19 vaccines, as well as any vaccine candidates in development.

At this stage, the key antisera and antigens of interest for the May 2025 decision-making meeting for demonstrating breadth include antisera to: BA.2 (other historical reference viruses – e.g., index virus, Alpha, BA.1 – are also useful for determining antigenic relationships), XBB.1.5, JN.1, KP.2, XEC, LP.8.1, LF.7.2 and potentially emerging SARS-CoV-2 variants. Antisera of interest are animal sera after single or sequential exposure and human sera after a boost with monovalent JN.1, KP.2 or XBB.1.5 vaccines. Both pre- and post-vaccination sera should be included and, for all antisera, neutralizing antibody titers should be analyzed against at least one variant that emerged after the vaccine antigen, where feasible. Analysis of these antisera against the same panel of virus antigens as well as other new emerging SARS-CoV-2 variants will provide insight into antigenic characteristics of previous and emerging variants. Emerging variants include the list of SARS-CoV-2 Variants of Interest (VOI) and Variants Under Monitoring (VUM) maintained on the WHO website. Relative VE estimates should be calculated during periods of circulation of XBB, JN.1, KP.3.1.1, XEC or other emerging variant(s) in human populations across age groups, with separate VE estimates for each of the following vaccine antigen compositions: monovalent JN.1, monovalent KP.2 or monovalent XBB.1.5. Where available, the underlying rates of disease outcomes used to derive the relative VE estimates should also be provided.

In preparation for the May 2025 meeting, the TAG-CO-VAC encourages the scientific community and vaccine manufacturers to prioritize generating and sharing the data outlined in the Table below to ensure evidence-informed deliberations on COVID-19 vaccine antigen composition; please contact the TAG-CO-VAC Secretariat: [tagcovac@who.int].

+ WHO website: https://www.who.int/activities/tracking-SARS-CoV-2-variants   

* Key emerging variants that evolve and considered relevant for demonstrating breadth include the list of Variants of Interest (VOI) and Variants Under Monitoring (VUM). This list is maintained on the WHO website: https://www.who.int/activities/tracking-SARS-CoV-2-variants   

References

1. World Health Organization. Types of data requested to inform December 2024 COVID-19 vaccine antigen composition deliberations. 7 October 2024. Available from: https://www.who.int/news/item/07-10-2024-types-of-data-requested-to-inform-december-2024-covid-19-vaccine-antigen-composition-deliberations
2. World Health Organization. Interim statement on the composition of current COVID-19 vaccines. 17 June 2022. Available from: https://www.who.int/news/item/17-06-2022-interim-statement-on--the-composition-of-current-COVID-19-vaccines.
3. World Health Organization. Statement on the antigen composition of COVID-19 vaccines. 18 May 2023. Available from: https://www.who.int/news/item/18-05-2023-statement-on-the-antigen-composition-of-covid-19-vaccines.
4. World Health Organization. Statement on the antigen composition of COVID-19 vaccines. 13 December 2023. Available from: https://www.who.int/news/item/13-12-2023-statement-on-the-antigen-composition-of-covid-19-vaccines.
5. World Health Organization. Statement on the antigen composition of COVID-19 vaccines. 26 April 2024. Available from: https://www.who.int/news/item/26-04-2024-statement-on-the-antigen-composition-of-covid-19-vaccines.
6. World Health Organization. Statement on the antigen composition of COVID-19 vaccines. 23 December 2024. Available from: https://www.who.int/news/item/23-12-2024-statement-on-the-antigen-composition-of-covid-19-vaccines

The number of children dying globally before their fifth birthday declined to 4.8 million in 2023, while stillbirths declined modestly, still remaining around 1.9 million, according to two new reports released today by the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME).

Since 2000, child deaths have dropped by more than half and stillbirths by over a third, fuelled by sustained investments in child survival worldwide. In 2022, the world reached a historic milestone when child deaths dropped slightly below 5 million for the first time. However, progress has slowed and too many children are still being lost to preventable causes.

"Millions of children are alive today because of the global commitment to proven interventions, such as vaccines, nutrition, and access to safe water and basic sanitation,” said UNICEF Executive Director Catherine Russell. “Bringing preventable child deaths to a record low is a remarkable achievement. But without the right policy choices and adequate investment, we risk reversing these hard-earned gains, with millions more children dying from preventable causes. We cannot allow that to happen.”

Decades of progress in child survival are now at risk as major donors have announced or indicated significant funding cuts to aid ahead. Reduced global funding for life-saving child survival programmes is causing health-care worker shortages, clinic closures, vaccination programme disruptions, and a lack of essential supplies, such as malaria treatments. These cuts are severely impacting regions in humanitarian crises, debt-stricken countries, and areas with already high child mortality rates. Global funding cuts could also undermine monitoring and tracking efforts, making it harder to reach the most vulnerable children, the Inter-agency Group warned.

“From tackling malaria to preventing stillbirths and ensuring evidence-based care for the tiniest babies, we can make a difference for millions of families,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “In the face of global funding cuts, there is a need more than ever to step up collaboration to protect and improve children’s health.”

Even before the current funding crisis, the pace of progress on child survival had already slowed. Since 2015, the annual rate of reduction of under-five mortality has slowed by 42%, and stillbirth reduction has slowed by 53%, compared to 2000–2015.

Almost half of under-five deaths happen within the first month of life, mostly due to premature birth and complications during labour. Beyond the newborn period, infectious diseases, including acute respiratory infections such as pneumonia, malaria, and diarrhoea, are the leading causes of preventable child death. Meanwhile, 45% of late stillbirths occur during labour, often due to maternal infections, prolonged or obstructed labour, and lack of timely medical intervention.

Better access to quality maternal, newborn, and child health care at all levels of the health system will save many more lives, according to the reports. This includes promotive and preventive care in communities, timely visits to health facilities and health professionals at birth, high-quality antenatal and postnatal care, well-child preventive care such as routine vaccinations and comprehensive nutrition programmes, diagnosis and treatment for common childhood illnesses, and specialized care for small and sick newborns.

“Most preventable child deaths occur in low-income countries, where essential services, vaccines, and treatments are often inaccessible”, said Juan Pablo Uribe, World Bank Global Director for Health and Director of the Global Financing Facility. “Investing in children's health ensures their survival, education, and future contributions to the workforce. With strategic investments and strong political will, we can continue to reduce child mortality, unlocking economic growth and employment opportunities that benefit the entire world.”

The reports also show that where a child is born greatly influences their chances of survival. The risk of death before age five is 80 times higher in the highest-mortality country than the lowest-mortality country, for example, while a child born in sub-Saharan Africa is on average 18 times more likely to die before turning five than one born in Australia and New Zealand. Within countries, the poorest children, those living in rural areas, and those with less-educated mothers face the higher risks.

Stillbirth disparities are just as severe, with nearly 80% occurring in sub-Saharan Africa and Southern Asia, where women are six to eight times more likely to experience a stillbirth than women in Europe or North America. Meanwhile, women in low-income countries are eight times more likely to experience a stillbirth than those in high-income countries.

“Disparities in child mortality across and within nations remain one of the greatest challenges of our time,” said the UN DESA Under-Secretary-General, Li Junhua. “Reducing such differences is not just a moral imperative but also a fundamental step towards sustainable development and global equity. Every child deserves a fair chance at life, and it is our collective responsibility to ensure that no child is left behind.”

UN IGME members call on governments, donors, and partners across the private and public sectors to protect the hard-won gains in saving children’s lives and accelerate efforts. Increased investments, service integration, and innovations are urgently needed to scale up access to proven life-saving health, nutrition, and social protection services for children and pregnant mothers.    

Notes to editors

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The UN IGME child mortality report

The UN IGME stillbirth report

The two reports – Levels & Trends in Child Mortality and Counting Every Stillbirth – are the first of a series of important global data sets released in 2025. UN maternal mortality figures will be published in the coming weeks.

About UN IGME

The United Nations Inter-agency Group for Child Mortality Estimation or UN IGME was formed in 2004 to share data on child mortality, improve methods for child mortality estimation, report on progress towards child survival goals and enhance the capacity of countries to produce timely and properly evaluated estimates of child mortality. UN IGME is led by UNICEF and includes the World Health Organization, the World Bank Group and the Population Division of the United Nations Department of Economic and Social Affairs.

 For more information: http://www.childmortality.org/